Health

A composer worked with patients in therapy. They created beautiful music together

A pilot program brought patients from the Centre for Addiction and Mental Health together with a composer for 8 weeks. The end result was a near 10 minute piece of classical music that will eventually take the stage with the Toronto Symphony Orchestra.

Over 8 weeks, patients met to talk about the music in their lives

A small ensemble performs music inside a room with large glass windows and a wooden floor.
Musicians from the Toronto Symphony Orchestra perform To Live, Ikiru at the Centre for Addiction and Mental Health in Toronto on June 11, 2023. The composition was made with input from clients of the hospital. (Anand Ram/CBC)

As the rain died down on a Monday evening in Toronto's downtown, a group gathered in an auditorium for a private concert with eight world-class musicians from the Toronto Symphony Orchestra. 

Beyond the occasional sounds of ambulance sirens bending by, and a speech-halting intercom message, there were few reminders that this was a hospital — the Centre for Addiction and Mental Health (CAMH). 

And when the first notes played, the small crowd was transported.

LISTEN | A sample of the piece that eight weeks of group discussions helped create:
Inspired by current clients of the Centre for Addiction and Mental Health, this is a sample of a piece of original music written by Métis and French-Canadian composer Ian Cusson and played by eight members of the Toronto Symphony Orchestra as part of a joint pilot project focused on healing

"It sort of felt like a new day coming about," said Bruce King of the performance. "And, sort of, being a part of that in nature."

Alex Abramenko remarked that the piece was "very romantic, very colourful, very vivacious." He said it was like listening to a love song.

But Abramenko and King weren't just audience members. They, along with other CAMH clients also in the crowd that evening, were instrumental in the creation of this piece. It's all part of a new program that seeks to combine the healing power of music with culturally relevant Indigenous knowledge. 

Leap of faith

"We invited our patients to be able to come and kind of take a bit of a leap of faith," said Renee Linklater, the senior director of Shkaabe Makwa, part of the CAMH that's centred on Indigenous-focused wellness. This pilot also involved non-Indigenous clients.

The ask was simple: talk about music, to help a composer write an original piece. 

"I know initially that might not have seemed so inviting for some people," Linklater said, knowing that a few people were shy and not open about coming forward with their thoughts. A clinical practice leader was also present at these sessions, helping facilitate discussions. 

"It's funny because we weren't really gathering to talk about our lives," recalled Ian Cusson, a composer of Georgian Bay Métis and French-Canadian descent.

A man uses a microphone to speak to a small crowd.
Composer Ian Cusson addresses the crowd before the performance. (Anand Ram/CBC)

"But in talking about the music that we loved, we couldn't avoid sharing." 

In his eight weeks with the group, Cusson says the music they listened to covered 800 years, sparking discussions of how it made them feel.

Finding their sound 

For King, sharing itself was a journey of identity. He recalls listening to Pavarotti and Bach the week before it was his turn to share music with the group. 

"I was trying to find this piece that was so moving to me — but I couldn't find it," he said. 

A man sits on a bench indoors.
Bruce King sits outside an auditorium space at the Centre for Addiction and Mental Health in Toronto. (Anand Ram/CBC)

Ultimately, those classical elements were found in an artist he listened to more often, the socially conscious rapper KRS One.

"And it just spoke to me. The song was Re Mind [Yourself], which was about talking about the fact that we can create anything that we want," he said. 

King, who says he's non-status Indigenous, described a "weird, surreal and subliminal relationship with the music" that people would share, and quickly found himself eager to attend every week. Abramenko had a similar journey. 

"I actually grilled Ian on what this is all about because I didn't quite understand," Abramenko said of the initial experience, expecting something closer to therapy.

A man sits in front of a window.
Alex Abramenko was one of the participants in this pilot project and describes the final piece as ‘romantic.’ (Anand Ram/CBC)

"And about a third of the way through the course, I realized that it wasn't about that at all. It was actually about coming together — and a sort of psycho-magical experience, if you will." 

Abramenko, who is open about his depression, anxiety and borderline personality disorder, says the project elevated music as a much more "non-negotiable" and "conscious" aspect to the process of working on his mental health.

Indirect medium

For Sarah Bell, a music therapist and counsellor in the Annapolis Valley in Nova Scotia, music opens up a pathway for non-verbal expression.

"Music is the background of people's lives," Bell said. "Someone who's, let's say, struggling with a certain emotion.… They might be able to say, 'Yeah, this song is how I feel.' Versus having the words to be able to say that."

Bell, who was not involved in the project, uses non-invasive techniques such as songwriting or analyzing the lyrics of a song to help people of all ages, even those at the end of life. 

She described how this might work for a patient under palliative care, whose "breathing is really heavy." 

"I might play a guitar to help accompany their breath and maybe that will help them to feel connected with someone, even if they're maybe not able to say it."

A sacred space

Bell is quick to remind that Indigenous healing has involved music for centuries, all around the world and different across cultures. For Linklater, of Rainy River First Nations in Ontario, creating a "culturally safe space" for this pilot was important.

A woman stands near a wall.
Renee Linklater, senior director of Shkaabe Makwa, at the Centre for Addiction and Mental Health in Toronto. (Anand Ram/CBC)

"We have cedar all around the walls," Linklater said of the room where sessions were held. It also had a medicine wheel painted on the floor.

"So that's a sacred space. And so we brought them [there] in order to be together as sacred beings to go create." 

Linklater hopes Indigenous people who access mental health services can see programs like this as a part of their healing journey. 

To live on 

The piece will be expanded next year with fuller orchestration in the 2023/24 season. For Cusson, who was also inspired by Akira Kurosawa's film Ikiru (the near-10-minute piece that he composed is called To Live, Ikiru), the project left him changed.

A man sits on a bench in front of a piano, looking to the side.
Composer Ian Cusson says the project gave him some much-needed connection with others. (Anand Ram/CBC)

"I realized how starved for people I was," Cusson explained after the performance that night, describing those feelings as a holdover of the pandemic. 

"So these weekly meetings became actual touchpoints in my week, of connecting with people in a fairly relaxed way over something that we all could talk about on some level: music."

That connection and retention, Linklater says, is part of the pilot's success. 

"We were able to have 10 people begin the group. I would say that it is miraculous that in week eight, eight of those people were still part of the group."

ABOUT THE AUTHOR

Anand Ram

Producer

Anand Ram is a reporter and producer with CBC's science and climate unit. He's worked as a reporter covering technology, business and the environment and as a producer with The National.